HomeMy WebLinkAbout1901-0308 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/15/2019 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Re-roof
PROPOSED.INPROVEMENT LOCATION.
Address: 5102 Palmetto Ave
Property Tax ID#: 3404-501-0620-300-2 Lot No.
Project Name:
DETAILED DESCRIPTION,OF WORK:
Remove existing roof and renail plywood. Apply self adhering shingle underlayment. Install 30 ft.of ridge vent.
Install dimensional shingles.
CONSTRUCTION INFORMATION:
Utilities: Sewer _Septic Sq. Ft.of First Floor:
Cost of Construction:$ 12,500.00 Total Sq. Ft of Construction: 2800
FLOODPLAIN'DEVELOPMENT PERMIT for structures exempt from Building Code that are in the
floodplain:
Nonresidential Farm Building: Temp. Bldg./Shed used.exclusively for construction,:
IVlobile/Modular for temp. construction office:, . Bldg. involved in distrib. of electricity:
Other:' Flood Zone:_ BFf:_ , FloodWay?`Y/N If Y,,,
No Rise Certificate with supporting data attached?Y/N'
All other applicable state and federal permits shall,be obtained prior to commencement of
construction.
OWNER/LESSEE: CONTRACTOR:
NameRichard Bergen Name:David Packard
Address:5102 Palmetto Ave Company:Packard Roofing&Waterproofing, Inc.
City: Ft. Pierce FL State:_ Address:2182 NW Reserve Park Trace
Zip Code: 34982 Fax: City: Port St. Lucie, State:FL
Phone No. Zip Code: 34986 Fax: 772-468-9978
E-Mail: Phone No772-468-3723
Fill in fee simple Title Holder on next page(if different E-Mailssmith@packardroofing.com
from the Owner listed above) State or County License CCCA17517
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
7
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:. Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:; Address:
City: i City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5+. Lock-,— COUNTY OF SA Lv cy>-(
The foroing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 154%y of 'ft� gds)GLl�/ 2011 q by this 15my of sa w mL..e 20_1a by
Name of person making statement. Name of person making statement.
Personally Known %"/ OR Produced Identification Personally Known *-" OR Produced Identification
Type of Identification Type of Identification
Produced Produced
MIT
(Signature of Notary Pu ic��+ f FIRS ablic-State of Florida (Signature of Nota u 1'F-,,State of FSIs FidliljP.SMITH
•
Commission tl GG 139524 a°; L� '' Notary Public-State of Florida
Commission No. : QB My .jExplres5ep2,2021 • +�._ Commissigrdl�iSV�39524
Fha6cnalNotAryAss°. Commission No. • 25
cF -.•' Bcrded ti ro,r o: My Comm.E pires p 2,2021
Bcrded throuSF Nation al NetaryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1/9/2019